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No. 95 August 1995
PREDICTORS OF INADEQUATE GESTATIONAL WEIGHT GAIN
AMONG AFRICAN AMERICANS AND NON-HISPANIC WHITES
... *.n,,£V:'^
Elizabeth Earnett PhD
Trude Bennett, DrPH
ABSTRACT
NX ^RARY
J
Inadequate maternal weight gain during pregnancy is the second leading determinant of low birth weight in
industrialized nations, preceded only by cigarette smoking. In this study, maternal sociodemographic,
nutritional, behavioral, health services, and reproductive history risk factors were investigated as potential
predictors of inadequate weight gain in a large (n=47,629) population of low-income women who were
underweight or normal weight prior to pregnancy, and who delivered full-term infants. Two outcomes were
analyzed gain ofless than 1 5 pounds at term (very inadequate gain) and gain ofat least 1 5 pounds but less than
the minimum recommended for prepregnancy body mass (moderately inadequate gain).
Overall, 35 .6 percent ofAfrican Americans and 25 percent ofnon-Hispanic whites had inadequate gain. The
strongest predictor ofpoor gain for both race groups was short interbirth interval; the adjusted relative risk of
very inadequate gain for women with birth intervals of 12 months or less was 1.5 (95% confidence interval (CI)
1 . 1 -2. 1) for African Americans and 2.2 (95% CI 1 .4-3.4) for non-Hispanic whites, compared with primiparous
women. Cigarette smoking, low education, and being unmarried were also important predictors ofpoor gain.
Timing of entry into prenatal health services was not predictive ofpoor gain. Compared with normal weight
women, underweight women were at lower risk of very inadequate gain but at higher risk of moderately
inadequate gain
Improved access to health services, including family planning, as well as nutrition education, greater food
supplementation for high-risk women, and smoking cessation programs may help to reduce the prevalence of
low birth weight by contributing to higher gestational weight gains.
ACKNOWLEDGEMENTS
This study was supported in part by cooperative agreement No. U50/CCU403457 with the Division ofNutrition,
Centers for Disease Control and Prevention, Atlanta, and in part by the North Carolina WIC Program. Dr. Bennett
is with the Department of Maternal and Child Health, UNC School of Public Health. Dr. Bamett was supported by
a Healthy People 2000 Data Initiative grant from the National Center for Health Statistics at the time of this study.
The authors thank Alice Lenihan and Paul Buescher for helpful comments on an earlier draft of this paper.
jSjfT^i NORTH CAROLINA DEPARTMENT OF ENVIRONMENT. HEALTH. AND NATURAL RESOURCES
DEHINIR

No. 95 August 1995
PREDICTORS OF INADEQUATE GESTATIONAL WEIGHT GAIN
AMONG AFRICAN AMERICANS AND NON-HISPANIC WHITES
... *.n,,£V:'^
Elizabeth Earnett PhD
Trude Bennett, DrPH
ABSTRACT
NX ^RARY
J
Inadequate maternal weight gain during pregnancy is the second leading determinant of low birth weight in
industrialized nations, preceded only by cigarette smoking. In this study, maternal sociodemographic,
nutritional, behavioral, health services, and reproductive history risk factors were investigated as potential
predictors of inadequate weight gain in a large (n=47,629) population of low-income women who were
underweight or normal weight prior to pregnancy, and who delivered full-term infants. Two outcomes were
analyzed gain ofless than 1 5 pounds at term (very inadequate gain) and gain ofat least 1 5 pounds but less than
the minimum recommended for prepregnancy body mass (moderately inadequate gain).
Overall, 35 .6 percent ofAfrican Americans and 25 percent ofnon-Hispanic whites had inadequate gain. The
strongest predictor ofpoor gain for both race groups was short interbirth interval; the adjusted relative risk of
very inadequate gain for women with birth intervals of 12 months or less was 1.5 (95% confidence interval (CI)
1 . 1 -2. 1) for African Americans and 2.2 (95% CI 1 .4-3.4) for non-Hispanic whites, compared with primiparous
women. Cigarette smoking, low education, and being unmarried were also important predictors ofpoor gain.
Timing of entry into prenatal health services was not predictive ofpoor gain. Compared with normal weight
women, underweight women were at lower risk of very inadequate gain but at higher risk of moderately
inadequate gain
Improved access to health services, including family planning, as well as nutrition education, greater food
supplementation for high-risk women, and smoking cessation programs may help to reduce the prevalence of
low birth weight by contributing to higher gestational weight gains.
ACKNOWLEDGEMENTS
This study was supported in part by cooperative agreement No. U50/CCU403457 with the Division ofNutrition,
Centers for Disease Control and Prevention, Atlanta, and in part by the North Carolina WIC Program. Dr. Bennett
is with the Department of Maternal and Child Health, UNC School of Public Health. Dr. Bamett was supported by
a Healthy People 2000 Data Initiative grant from the National Center for Health Statistics at the time of this study.
The authors thank Alice Lenihan and Paul Buescher for helpful comments on an earlier draft of this paper.
jSjfT^i NORTH CAROLINA DEPARTMENT OF ENVIRONMENT. HEALTH. AND NATURAL RESOURCES
DEHINIR